Dr. med. Dirk Manski

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Prostate Cancer: Definition and Epidemiology

Guidelines and review literature: (EAU Guidelines, Mottet et al, 2020) (S3-Leitlinie Prostatakarzinom der DGU) (Walsh-Campbell Urology 11th Edition).

Definition of Prostate Cancer

Prostate cancer is a common adenocarcinoma of the prostate with very variable clinical course.

Abbildung TRUS eines Prostatakarzinoms

Transrectal ultrasound of prostate cancer: prostate cancer foci may present as hypoechoic areas, but more often the foci of prostate cancer are unrecognizable with ultrasound imaging.

Epidemiology of Prostate Cancer

Prostate cancer is the most common cancer in Germany. It is the third most common cause for cancer death (10%). In 2012, approximately 64000 men in Germany were diagnosed with prostate cancer. Mortality is decreasing to about 20-30/100000 men. 12400 men died 2012 from prostate cancer in Germany. (Crawford, 2003) (Gronberg, 2003).

Age of onset:

The average age at diagnosis is 71.4 years, the average age for death due to prostate cancer is 78 years. 5-year survival rate is thus the rule and therefore 5-year survival rates are not helpful to judge the effectiveness of a treatment option. The diagnosis "prostate cancer" reduces the 5-year survival rate by 1% and 10-year survival rate by 5%, compared to the age group without prostate cancer diagnosis.

Incidence of prostate cancer:

There are great differences between the geographical origin and ethnicity: the incidence in the US is between 110 (white americans) and 170 (black americans). In Spain the incidence is 36/100000 men, in Sweden 91/100000 men. The incidence in Germany is estimated to be around 110/100000 men. The annual incidence rate increases with age, from about 50/100000 in 60 year old men to more than 400/100000 in men between 75 to 85 years.

Prevalence of prostate cancer:

The prevalence of prostate cancer ammounts to 50–64% in men aged 60–80 years, the data are derived from autopsy studies. The high prevalence also includes a high proportion of small prostate tumors with good differentiation, which are not clinically significant. Approximately 40% of the male population in Germany carry the risk of developing prostate cancer during their lifetime. Only about 10% are symptomatic and only 3% die from prostate cancer. This means up to 90% of pathologically discoverable carcinomas do not lead to death.

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N. Mottet (Chair), J. Bellmunt, E. Briers (Patient Representative), R.C.N. van den Bergh (Guidelines Associate), M. Bolla, N.J. van Casteren (Guidelines Associate), P. Cornford, S. Culine, S. Joniau, T. Lam, M.D. Mason, V. Matveev, H. van der Poel, T.H. van der Kwast, O. Rouvière, T. Wiegel
Guidelines on Prostate Cancer of the European Association of Urology (EAU), https://uroweb.org/guideline/prostate-cancer/.

Krebs in Deutschland. www.krebsdaten.de

Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF):
Interdisziplinäre Leitlinie der Qualität S3 zur Früherkennung, Diagnose und Therapie der verschiedenen Stadien des Prostatakarzinoms, Langversion 3.1, 2014 AWMF Registernummer: 034/022OL, http://www.awmf.org/leitlinien/detail/ll/043-022OL.html (Zugriff am: 07.02.2016)

Wein, A. J.; Kavoussi, L. R.; Partin, A. P. & Peters, C. A.
Campbell-Walsh Urology.
Elsevier, 11th Edition, 2015. ISBN 978-1455775675.

  Deutsche Version: Prostatakarzinom